Healthcare Provider Details

I. General information

NPI: 1477744035
Provider Name (Legal Business Name): SACHIN VIJAYKUMAR PHADE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2007
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7425 ZIEGLER RD STE 101
CHATTANOOGA TN
37421-4178
US

IV. Provider business mailing address

4976 ALPHA LN
HIXSON TN
37343-5470
US

V. Phone/Fax

Practice location:
  • Phone: 423-702-9218
  • Fax: 423-702-9219
Mailing address:
  • Phone: 423-497-5355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number47447
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number47447
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: